Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samuel Clark, AGACNP

Individual provider Registered Nurse · NPI 1417706623

Samuel Clark, AGACNP is a Nurse Practitioner in Newark, Delaware. Qualified in 2021, 5 years ago. Practices with Christiana Care Health Services Inc, a 1,481-clinician group and accepts Medicare assignment. Licensed in Delaware.

Years since qualifying
5
Licensed in
DE
In the registry since
2024
Specialties on file
3
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Practice location Address checks out

4755 Ogletown Stanton Rd Ste 2E99
Newark, DE 19718-2200
Phone: (302) 733-5982
Fax: (302) 733-6081
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence LP-0010513 (DE)
Registered Nurse Taxonomy 163W00000X · Licence L1-0048020 (DE)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence LP-0010513 (DE)

Record details

NPI number1417706623
Entity typeIndividual (Type 1)
GenderMale
Credentials AGACNP
Sole proprietorNo
NPI enumeratedMay 20, 2024
Last updated in NPPESJuly 12, 2024
Certification dateJuly 12, 2024
Mailing address3566 Main St, Frederica, DE 19946-1265

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Christiana Care Health Services Inc — 1481 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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